Active NPI
Andrea Elizabeth Bravo Echegollen, RBT
- Behavior Technician
- Sacramento, CA
National Provider Identifier
1801377312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-18-63294
- Practice address
- 6000 J St
Sacramento, CA 95819-6073 - Phone
- (916) 548-2562
- NPI assigned
- Aug 22, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-18-63294 | CA | Primary |
Addresses
Primary practice location
6000 J St
Sacramento, CA 95819-6073
Mailing address
2454 Heartland Dr
Riverbank, CA 95367-9466
Phone (209) 342-8413
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-18-63294 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534896000000",
"number": "1801377312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2454 HEARTLAND DR",
"city": "RIVERBANK",
"state": "CA",
"postal_code": "953679466",
"telephone_number": "209-342-8413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6000 J ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958196073",
"telephone_number": "916-548-2562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAVO ECHEGOLLEN",
"first_name": "ANDREA",
"middle_name": "ELIZABETH",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-22",
"last_updated": "2018-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-18-63294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.